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World TB Day 2023

March 24th is World Tuberculosis Day. The observance is an opportunity to shine a light on one of the world's oldest and deadliest diseases. This year's theme is "Yes! We can end TB!"

The date chosen for the observance, March 24, commemorates Dr. Robert Koch's 1882 discovery of Mycobacterium tuberculosis, the bacterium that causes the disease. It was the first step on the journey toward reining in this merciless killer, which culminated in the discovery and eventual mass production of antibiotics in the middle of the 20th century.

Tuberculosis, or TB, has plagued humans for thousands of years. Researchers found its sign in six thousand year old human skeletons, and in the spines of five thousand year old Egyptian mummies. Indeed, Mycobacterium tuberculosis is believed to have evolved along with people - and it is still evolving.

With the advent of the Industrial Revolution, the disease began to spread faster and more widely. As populations grew, people looking for employment began to migrate into cities. Overcrowded living conditions, lack of proper hygiene and nutrition, along with poor ventilation created the perfect conditions for the spread of this contagious illness. By the late nineteenth century, Tuberculosis was one of the most feared diseases, reaching epidemic levels in Europe and the Americas and causing one out of every seven deaths.

Today, TB is still the world's deadliest infectious disease, causing the deaths of nearly 1.5 million people each year, most of them impoverished. It is no coincidence that the infection rate of TB within a population is one of the indicators of development. Those who lack access to good, nutritious food and to medical care are less likely to recover from TB, or to avoid it altogether. With treatment, recovery rate stands at about 85 percent. Without treatment, TB kills half of its victims.

"Everyone should be able to lead a healthy, productive, and fulfilling life. That's our goal," said President Joe Biden at last year's 7th Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

"Let's finish this fight together. Now is the moment to accelerate our efforts to reduce health inequities and to address barriers to access, including gender and human rights barriers; to build a more inclusive healthcare systems to leave no one behind; to end … tuberculosis … for good."

World Tuberculosis Day 2023: 10 Myths About TB BUSTED - Check How It Spreads

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Caused by the bacteria Mycobacterium tuberculosis, TB most often affects the lungs. Tuberculosis or TB is spread through the air when people who have lung TB cough, sneeze, or spit. According to the World Health Organization (WHO), a person needs to inhale only a few germs to become infected with TB. On March 24, World Tuberculosis Day is observed and the aim of this day is to educate the world about the impact of tuberculosis and check its spread. On March 24, 1882, German physician Dr Robert Koch announced the discovery of Mycobacterium tuberculosis, the bacteria that caused TB. 100 years later, the first World Tuberculosis Day was celebrated.

World Tuberculosis Day: How TB Spreads And Symptoms of TB

According to the WHO,  about half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines, and South Africa. Dr Ambarish Joshi, Sr Consultant Pulmonology, Primus Super Speciality Hospital, shares, "Tuberculosis (TB) is an infectious illness caused by the bacterium Mycobacterium tuberculosis. TB mainly affects the lungs, but it can also affect the kidneys, spine, and brain. When an infected person coughs or sneezes, TB spreads through the air, and it is more prevalent in areas with poor ventilation and crowded living conditions. Coughing, chest discomfort, fever, and weight loss are all symptoms of tuberculosis."

World Tuberculosis Day: Debunking Myths

On World Tuberculosis Day, Dr Ambarish Joshi debunks 10 common myths about tuberculosis (TB): 

Myth 1: Only poor people get TB.

Fact: TB can affect anyone regardless of their socio-economic status, age, or gender.

Myth 2: TB is a disease of the past.

Fact: TB is still a major global health threat and is one of the top 10 causes of death worldwide.

Myth 3: TB is only transmitted through coughing and sneezing.

Fact: TB can also be transmitted through contaminated food, water, or unpasteurized milk.

Myth 4: TB only affects the lungs.

Fact: While pulmonary TB is the most common form, TB can also affect other parts of the body, such as the bones, lymph nodes, and brain.

Myth 5: TB is easy to diagnose.

Fact: TB can be difficult to diagnose as its symptoms are similar to other respiratory illnesses, and some strains of TB are resistant to certain drugs.

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Myth 6: TB is always fatal.

Fact: TB can be cured with a full course of antibiotics and proper treatment.

Myth 7: TB only affects older people.

Fact: TB can affect people of all ages, but those with weakened immune systems or underlying health conditions are more susceptible.

Myth 8: TB is not contagious if the person doesn't show symptoms.

Fact: People with latent TB can still spread the disease, even if they don't show any symptoms.

Myth 9: TB can be cured with traditional remedies.

Fact: TB can only be cured with a proper course of antibiotics prescribed by a healthcare professional.

Myth 10: TB is not a global health threat.

Fact: TB is a major global health threat, particularly in developing countries with limited access to healthcare and proper treatment.

World TB Day: 25% Of All TB Cases Are In Africa, And So Are The Deaths

The First National TB Prevalence Survey from 2018 indicates that South Africa is one of the 30 nations with a high burden of tuberculosis (TB), accounting for 87% of the estimated incidence. On its own, SA accounts for 3% of all TB cases worldwide.

South Africa continues to be negatively impacted by TB, which is a cause for serious concern. It has the highest incidence rate of TB in Africa, with approximately 301 000 cases annually. TB also remains among the leading causes of death for those infected with HIV.

In commemoration of World TB Day, the theme for 2023 is "Yes! We can end TB!" which looks at how TB is preventable and curable. Sadly, Africa continues to be plagued by tuberculosis, as a staggering 10 million individuals succumb to the disease each year.

There are various reasons for the high incidence rate of TB in South Africa and Africa as a whole. Poverty, overcrowding, and malnutrition are some of the factors that contribute to the high prevalence of the disease. Additionally, cultural beliefs and a lack of awareness can lead to those infected with TB not seeking medical attention, thus increasing the risk of the disease spreading.

Why treatment is vital

One of the most significant challenges in treating TB is the lengthy period it takes to cure the disease – up to 6 months of daily medication. The risk of drug-resistant TB also increases if the medication is not taken correctly or if treatment is interrupted.

Effective treatment is essential, not only for the health of the individual but also to prevent the spread of TB within communities. Early diagnosis, successful treatment, and social support are all critical factors in managing TB.

Strides made in the treatment

Although, there have been significant advances in TB treatment in recent years, including the development of new drug regimens and diagnostic tools. South Africa has implemented a comprehensive TB control program, including the provision of free treatment and care, increased laboratory capacity, and the use of community healthcare workers to reach remote areas.

The reality in Africa

TB is the largest cause of death from a single infectious agent, according to Dr Allan Pamba, Executive Vice President, of Roche Diagnostics.

Further, 25% of all TB cases, as well as 25% of all deaths, occur in Africa.

"Africa's HIV burden causes further complications, as those infected with HIV are 18 times more likely to develop TB. The conditions form a lethal paradox, both accelerating the development of the other."

And 85% of TB patients in Africa are also HIV positive. Despite the stark reality, however, according to the World Health Organization (WHO), "Funding for TB prevention, diagnosis, and treatment services continues to fall far short of estimated global needs and the United Nations global target. In 2020, global spending on TB services fell to $5.3 billion, and funding for research was $901 million," said Dr Pamba in a statement.

He goes on to bring to attention that the most affected nations in Africa share the desire to eradicate tuberculosis, but funding mobilisation has lagged. Only 22% of the funds required to offer effective TB services in Africa are provided by the government, and 44% are still unfunded. This severely hampers efforts to lessen the TB burden.

Changing the narrative

"Without diagnostics, there can be no treatment. High-quality diagnostics are the cornerstone of any clinician's arsenal against disease. But presently, primary care medical facilities in many developing nations have significant gaps in access to critical diagnostic tools.

To quote the WHO, "Ending TB is not just a public health problem, but a development challenge and opportunity," said Dr Pamba.

While there is still much work to be done to address TB in South Africa, there is hope that with continued efforts, the disease can be eliminated. Treatment is vital, and with the right medical care, support, and awareness, we can end TB in our lifetime.

Read the latest issue of IOL Health digital magazine here.

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